The Unspoken Truth About Building a Therapy Practice

Justine shares the real story of building a therapy practice—the loneliness, the self-doubt, and the profound rewards of the client relationship.

There’s a picture many therapists have in their minds when they dream of private practice: a calm, beautifully decorated room, a full diary of ideal clients, and the deep satisfaction of doing meaningful work on their own terms. That picture is true, but it’s only half the story.

The other half is a journey filled with profound challenges, moments of crippling self-doubt, and a steep learning curve that no training course can fully prepare you for. After more than 20 years in this field, I wanted to share some of the unspoken truths—the trials and the triumphs—of building a practice from the ground up.

The Lows: The Unspoken Challenges

The early days of private practice can be intensely lonely. You go from a bustling training cohort, surrounded by peers, to sitting alone in a room, waiting for the phone to ring. The silence can be deafening, and it’s often filled with the voice of imposter syndrome.

• The Weight of the Empty Chair: You worry if you’re good enough, if you have what it takes, and if you can truly hold the responsibility of a client’s story.

• The Business Maze: Suddenly, you’re not just a therapist. You’re a marketer, an accountant, and a website designer. It can feel overwhelming and a million miles away from the client work you were trained to do.

• The Financial Anxiety: The pressure to get enough clients to pay the bills is very real, and it can sometimes feel at odds with the ethical, client-centred approach you want to maintain.

The Highs: The Moments That Make It All Worthwhile

For all its trials, building your own practice brings moments of fulfilment that are unlike anything else. These are the moments that remind you why you started.

• The First Client Who Trusts You: There is nothing like the feeling of that first person choosing you, trusting you with their story, and starting a journey with you.

• Witnessing a Real Breakthrough: The true magic of this work is seeing a client connect the dots, release an old pattern, or find a new sense of peace. To be a trusted witness to that kind of change is a profound privilege.

• Building Something That Is Truly Yours: Looking at a practice that you have built from scratch—one that reflects your values and your authentic way of working—is a source of incredible pride and satisfaction.

What Keeps Me Going? It’s Always the Relationship.

So, what makes me keep going through the tough times? The answer is simple: the therapeutic relationship.

The trust that a client places in you is a sacred thing. The connection built in the therapy room—that space of honesty, vulnerability, and genuine human contact—is the fuel that sustains this entire journey. It is the unwavering belief in the human capacity to heal and grow, and the honour of being able to walk alongside someone as they do that work. That is why it is all worth it.

If you’re a therapist on this path, be kind to yourself. Find good supervision, connect with your peers, and hold onto the moments of connection that matter. And if you’re someone looking for a therapist, know that the person sitting opposite you understands the courage it takes to show up—because they’ve had to find their own, too.

Get in touch to book and appointment and find out more